Aseptic Splenic Abscess and Sweet Syndrome
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Kelly Johnson
A 6-year-old child presented to the emergency department with left upper-quadrant abdominal tenderness and a persistent fever. He had a white blood cell count of 30,000/μL, and a computed tomographic image of the abdomen showed splenic fluid (image A). A splenic drainage tube was placed and collected aseptic fluid with neutrophilic infiltration, indicating an aseptic splenic abscess. After tube removal, a tender, raised, and ulcerated skin lesion appeared over the drain site with violaceous rolled borders. Another kissing lesion appeared on the medial left brachium at the site of the intravenous line (image B). Tissue samples revealed aseptic intraepithelial neutrophilic infiltration. Based on the persistent fever, elevated white blood cell count, and pyoderma gangrenosum, Sweet syndrome was diagnosed. The patient was treated with systemic cyclosporine, prednisone, and topical FK-506 and made an unremarkable recovery.
Sweet syndrome, also referred to as acute febrile neutrophilic dermatosis, is a hypersensitivity reaction with symptoms and laboratory findings of fever; neutrophilia; leukocytosis; an abrupt onset of tender, erythematous, and violaceous inflammatory papules, nodules, and plaques; and high inflammatory markers.1 Diagnostic criteria are outlined by von den Driesch,2 and treatment consists of systemic corticosteroids or potassium iodide.
References
1. Uihlein LC , Brandling-BennettHA, LioPA, LiangMG. Sweet syndrome in children. Pediatr Dermatol. 2012;29(1):38-44. doi:10.1111/j.1525-1470.2011.01534.x.10.1111/j.1525-1470.2011.01534.xSearch in Google Scholar
2. von den Driesch P . Sweet’s syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol. 1994;31(4):535-556. doi:10.1016/s0190-9622(94)70215-2.10.1016/S0190-9622(94)70215-2Search in Google Scholar
© 2016 American Osteopathic Association
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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- BOOK REVIEWS
- A View From the Inside: A Collection of Medically Oriented Short Stories
- EDITORIAL
- ENGAGE Initiative: Showcasing Osteopathic Scholarly Activity
- Building Primary Care Research Capacity in a College of Osteopathic Medicine
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- Interstate Medical Licensure Compact: Pernicious Myths and Inescapable Facts
- AOA COMMUNICATION
- Proposed Amendments to the AOA Constitution, Bylaws, and Code of Ethics
- ORIGINAL CONTRIBUTION
- Effectiveness of Home Blood Pressure Monitoring Among Low-Income Adults in Rural Appalachia
- CLINICAL REVIEW
- Is Meat Killing Us?
- MEDICAL EDUCATION
- Premedical Students’ Attitudes Toward Primary Care Medicine
- SPECIAL COMMUNICATION
- Growing Research Among Osteopathic Residents and Medical Students: A Consortium-Based Research Education Continuum Model
- CASE REPORT
- Intact Cornual Ectopic Pregnancy and Dermoid Cyst With Intraoperative Rupture
- Transient Ischemic Attack After Foam Sclerotherapy in a Woman With a Patent Foramen Ovale
- THE SOMATIC CONNECTION
- Eye Contact, Appetite, and Vomiting Improved in Children With Autism Spectrum Disorder After Visceral Osteopathic Technique
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